Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Septic shock is the primary cause of mortality in sepsis, with its core pathophysiological mechanism being severe ischemia and hypoxia in critical units—composed of microcirculation and the mitochondria of functional cells—resulting from disruptions in blood flow and oxygen flow following a dysregulated host response. Due to the systemically convergent yet clinically heterogeneous nature of the host response, current understanding and management strategies for hemodynamics remain inconsistent, often leading to inadequate resuscitation or overtreatment. To improve the quality of care, based on a systematic review of the "blood flow-oxygen flow" theory, an expert panel emphasizes reevaluating septic shock from an integrated perspective of blood flow and oxygen flow, and has formulated the Expert Consensus on Blood Flow and Oxygen Delivery Phenotyping and Clinical Management of Septic Shock (2025). The consensus proposes that clinical typing of blood flow-oxygen flow should comprehensively consider cardiac function, vascular tone, oxygen flow utilization status in critical units, and disease trajectory, while optimizing subtype identification by integrating host response phenotypes and artificial intelligence technologies. It advocates establishing a continuous assessment system through multi-site oxygen flow monitoring for organ perfusion, peripheral perfusion monitoring, and critical care ultrasound. Under the framework of the "critical care triangle", the consensus promotes the implementation of individualized, bundled management strategies, providing guidance for multiple management points to restore blood flow-oxygen flow matching, reduce the risk of organ failure, and decrease patient mortality.

ObjectiveTo construct and evaluate a mouse model that simulates the pathological progression of immune checkpoint inhibitor-associated pneumonitis (CIP), in order to address the critical issue of the lack of standardized animal models in this research field. MethodsThirty-five SPF-grade 6-week-old male C57BL/6J mice were randomly assigned to a control group (n=5), a bleomycin (BLM) group (n=15), and a BLM+programmed death-1 (PD-1) monoclonal antibody (BLM+PD-1) group (n=15). Corresponding drugs were administered via intraperitoneal injection for intervention. The general condition, body weight changes, survival rate, and pulmonary histopathological alterations were systematically monitored. ResultsCompared with the BLM group, the BLM+PD-1 group exhibited significantly more severe pulmonary fibrosis, characterized by progressive body weight loss and more severe deterioration of general conditions. Histopathological examination showed that pulmonary inflammation was alleviated 4 weeks post-modeling in the BLM group. In contrast, pulmonary lesions continued to worsen in the BLM+PD-1 group, with no evidence of resolution of inflammation 28 days post-modeling. Quantitative immunohistochemical analysis revealed that the positive expression rate of interleukin-17A (IL-17A) in lung tissues reached 34.28% in the BLM+PD-1 group 14 days post-modeling, which was markedly higher than that in the BLM group (24.02%, P < 0.000 1). The positive expression rate of α-smooth muscle actin (α-SMA) was 12.40% in the BLM+PD-1 group 14 days post-modeling, nearly twice the level in the BLM group (5.87%). 28 days post-modeling, the positive expression rate of α-SMA remained at 7.72% in the BLM+PD-1 group, while it declined to 3.38% in the BLM group. ConclusionThe addition of a PD-1 inhibitor to bleomycin treatment accelerates the progression of pulmonary interstitial fibrosis and effectively recapitulates the pathological process of lung injury and fibrosis driven by aberrant immune activation during clinical immunotherapy. Accordingly, this study successfully establishes a dynamic CIP animal model recapitulating the progression from early inflammatory response to pulmonary fibrosis. This model addresses the critical shortage of animal models for this condition and offers an experimental platform for further mechanistic studies and the development of therapeutic strategies.

Objective To explore the clinical application of a new laryngeal mask in implantation of tracheal stent.Methods The new laryngeal masks were implanted under general anesthesia for 20 patients with tracheal or primary bronchus stenosis.The oxygen was continuously supplied from its side hole,and the stents were subsequently implanted from the tail hole.Results By using the new laryngeal masks under general anesthesia,all of 20 patients were successfully and leisurely implanted the tracheal stent.After the operation,the dyspnea symptoms were significantly improved,and there was no complication.Conclusion Stent implantation by using the new laryngeal mask under general anesthesia will provide a safe and effective treatment for tracheal stenosis.

Objective To explore the therapeutic effects of pure collagenase injection and collagenase combined with herniation injection of ozone on the treatment of lumbar disc herniation(LDH).Methods According to the principle of randomized controlled double blind, 100 patients with LDH were divided into 2 groups:pure collagenase group and combined treatment group.Changes of NRS value and Macnab score were observed and recorded at multiple time points after operation.The difference of the effect of the two kinds of operation was analyzed.Results Among the 50 patients in the simple treatment group,3 patients were lost to follow-up.Among the 50 patients in the combined treatment group,2 patients were lost to follow-up,and open surgery in 2 patients because of poor efficacy after the injection of 3 months and 6 months respectively.By analyzing the change of NRS value and Macnab score of 2 groups patients,there was no significant difference in the short-term and long-term efficacy between the 2 groups(P>0.05);The symptoms of the 2 groups were improved after operation.The curative effect was positively correlated with the recovery time, and the difference was statistically significant (P<0.05).Conclusion The curative effect of pure collagenase injection and the combined with herniation injection of ozone are both significant, and there is no significant difference in the clinical efficacy between the 2 kinds of operations.

Objective The use of targeting therapy for the treatment of gastric glandular cancer has been a hot topic in recent years. This study aims to clarify that through what ways the histone deacetylase inhibitor MS-275 completes its selectively killing effect on gastric glandular cancer cell line SGC-7901. Methods SGC-7901 cells and GES-1 cells were respectively cultured for 24h, with(10-100) μmol/L concentrations of MS-275. (1) The survival rate of SGC-7901 cells, GES-1 cells and the normal cells were analyzed by WST-1; (2) The change of the mitochondrial membrane potential in SGC-7901 was estimated by flow cytometry;(3) The expression levels of p21, p27, p57, cyclinB1, cyclinD1 were determined by Western blot and PCR methods. Results (1) MS-275 could decrease the survival rate of SGC-7901 cells, the effect was significantly enhanced with the increasing of the concentration (P<0.05), but MS-275 showed no obvious effect on normal gastric mucosa epithelial cells GES-1; (2) MS-275 treatment could decreased the mitochondrial membrane potential of SGC-7901 cells (P<0.05); (3) MS-275 treatment could increase the relative contents of p21, p27, p57 genes and their protein and, at the same time, decrease the relative contents of CyclinB1 and CyclinD1 (P<0.05). Conclusion MS-275 treatment can selectively kill gastric glandular cancer cells SGC-7901 through several possible ways, such as inducing mitochondrial apoptosis and regulating the expression levels of cell cycle-related genes and proteins.

Objective To evaluate the clinical efficacy and safety of two kinds of uterine artery perfusion chemotherapy plus embolization (UACE) in treating ectopic pregnancy (EP). Methods A single center, randomized, double-blind, controlled clinical trial was carried out at authors hospital. A total of 50 cases of EP patients were randomly and equally divided into the study group (perfusion chemotherapy of MTX and 5-FU plus embolization therapy) and the control group (perfusion chemotherapy of pure MTX plus embolization therapy). After UACE, the serumβ-HCG value, the clinical healing time and the tubal patency rate were determined at different time, and the adverse events were recorded. The results were statistically analyzed by using t test, and χ2 test, and the data were compared between the two groups. Results One patient in both groups was excluded from the study. In the remaining 48 patients, one patient of the control group failed to respond the treatment, so the overall cure rate was 97.9%. The differences in the main effect of treatment method and the time interaction of the serum β-HCG values between the two groups were not statistically significant (P > 0.05), while the difference in the time effect between the two groups was statistically significant (P < 0.05). The clinical healing time of the study group and the control group was (28.57 ± 5.08) days and (26.74 ± 5.57) days respectively, and no statistically significant difference existed between the two groups(P>0.05). The tubal patency rate of the study group and the control group was 76.2%and 78.9%respectively, and no statistically significant difference existed between the two groups (P > 0.05). The adverse events in both groups were mild, and the occurrence of the adverse events in the study group and the control group was 58.3% and 26.1% respectively, and the difference between the two groups was statistically significant (P <0.05). Conclusion Two kinds of interventional methods have the same clinical curative effect. However, the incidence of adverse events in the control group is lower than that in the study group. Therefore, in treating ectopic pregnancy perfusion chemotherapy with MTX only is recommend.

ObjectiveTo observe the change of cardiac function after acute myocardial infarction (AMI) in rabbit model,and to study MRI characteristics of left ventricular remodeling (LVR).Methods Forty-five japanese white rabbits underwent chest-opening coronary artery ligation surgery to obtain rabbit myocardial infarction model The animals were scanned on a 1.5 T MR scanner ( GE Healthcare,Chalfont St.Giles,UK) at six time-points as surgery,1,2,4,6,8 weeks after surgery. Cardiac function parameters were measured,including left ventricular end diastolic volume ( EDV ),stroke volume ( SV ),ejection fraction (EF),peak ejection rate ( PER ) and peak firing rate (PFR).At each time point,5 rabbits were randomly selected and performed re-thoracotomy to obtain heart specimen.Each specimen was examined by MRI with the diffusion tensor imaging ( DTI ).The value of ADC and fractional anisotropy (FA) were collected. Cardiac function data sets of different time points were analyzed using repeated measures data of ANOVA.The FA and ADC values of infarction myocardium set of different time points or different parts of the myocardium were analyzed using one-way ANOVA. The average was compared statistically between two adjacent groups using LSD-t test. Results Left ventricular EDV increased in progress with the time.It was increased from ( 2.21 ± 0.35 ) ml preoperatively to ( 3.15 ± 0.57 ) ml 8-week postoperatively.But the difference was not statistical significant ( F =1.384,P =0.220).EF was decreased from(57.31 ± 11.11 )％ to( 34.71 ± 8.72 )％.It dropped significantly and the difference was statistically significant (F =27.134,P =0.001 ).EF showed a downward trend with the increase of EDV.By linear regression analysis,an equation was set up with y =- 5.58x + 57.7 ( F =8.855,P =0.005 ).On the other hand,PER showed a progressive decline from (27.31 ± 13.06) ml/s to ( 17.31 ± 6.41 ) ml/s ( F =2.105,P =0.037 ),and PFR decreased from ( 23.79 ± 14.15 ) ml/s to ( 12.07 ± 6.91 ) ml/s ( F =2.366,P =0.011 ).FA value decreased from 0.442 ±0.093 to 0.107 ±0.037( F =12.61,P =0.001 ),and ADC valueshowed upward trend from (5.07 ± 1.15) ×10-4 mm2/s to(6.39 ±0.78) ×10-4 mm2/s (F=4.166,P =0.022 ).FA values of infarct,adjacent and remote region were 0.201 ± 0.049,0.316 ± 0.127 and 0.323 ± 0.117 respectively( F =3.896,P =0.004 ),and the ADC values in these regions were (6.19 ± 1.78 ) ×10 -4,(5.44 ± 2.63 ) × 1 0 -4,(5.29 ± 2.02 ) × 10 -4 mm2/s respectively ( F =3.248,P =0.018 ).FA and ADC values were significantly different between the infarct region and adjacent region ( t =7.327,P =0.001 ;t =3.292,P =0.005,respectively),but there was no significantly different between adjacent region and remote region ( t =1.024,P =0.129 ; t =1.467,P =0.164,respectively ).ConclusionsMRI measurement of parameters of cardiac function can be used to monitor the process of left ventricular function remodeling after AMI.The process of micro-structural remodeling of myocardium can be reflected by DTI.MRI provides a feasible imaging modality for LVR after AMI.

For recent two decades,radiofrequency ablation technology(RFA)has made great progress in the field of the treatment for diseases for its distinguishing characteristic of microtrauma,targeted,effective and almost having no side-effect.At the very beginning,radiofrequency ablation was adopted in treating solid tumors,and since then it has been gradually practiced in treating benign diseases of solid organs such as hypersplenism,prostatic hyperplasia and widely used in almost every system of the body.Here,we review its therapic principle,types and clinical application.

Objective To investigate the apoptosis of gastric carcinoma SGC-7901 cell induced by histone deacetylase inhibitor(TSA)and to clarify its mechanisms.Methods The apoptosis-inducing role of TSA on gastric carcinoma SGC-7901 cell was investigated with the help of cell proliferation assay,Annexin V stain,cell flow analyzer and Tunel assay.Western blot,gene chips,real time PCR were employed to study the influence and mechanisms of TSA on the expression of gastric carcinoma cell SGC-7901 p53,bax,etc.Results TSA could induce the apoptosis of gastric carcinoma SGC-7901 cells,increase the expression of p53 and bax,and decrease the expression of bcl-2.survivin and easpase in gastric carcinoma SGC-7901 cells.TSA could transfer AIF and EndoG from mitochondria to nucleus.The apoptosis induced by TSA was brought about through the regulation of multiple apoptosis-related genes,and the apoptosis pathway induced by TSA was caspase-independent.Conclusion TSA can induce caspase-independent apoptosis in gastric carcinoma SGC-7901 cell through the regulation of multiple apoptosis-related genes.

Objective To evaluate the effectiveness and safety of interventional thermochemotherapy for VX2 transplanted hepatic tumor model in experimental rabbits.Methods The hepatic tumor model was established in 20 New Zealand rabbits by implanting VX2 tumor cells into the right hepatic lobes of the rabbits.The rabbits were randomly and equally divided into two groups with 10 rabbits in each group:group A (study group)and group B(control group).Via the femoral access,the catheter was placed into the tumorfeeding artery,which was confirmed by DSA.The rabbits in group A received an infusion of 100 ml 5% glucose plus 5-Fu(20 mg/kg)at 60℃ temperature,while the rabbits in group B received an infusion of 100 ml 5% glucose plus 5-Fu(20 mg/kg)at normal room temperature(22-25℃).Before and after the procedure,the tumor size was measured by means of B ultrasonography and the serum ALT was estimated to assess the liver function.The results were statistically compared between two groups.Results After the treatment,the tumor size in group A(study group)became much smaller than that in group B(control group),with P＜0.05.And no significant difference in the serum ALT level existed between group A and group B.Conclusion The interventional thermochemotherapy is superior to interventional chemotherapy in inhibiting VX2 transplanted hepatic tumor in experimental rabbits.